Laparoscopic surgeries often require the closing of wounds with sutures that require tying knots. However, with laparoscopic instruments in an intracorporeal environment, tying knots can be a challenging and time-consuming process.
Several suturing devices have been developed that can reduce or eliminate the difficulties and time involved with tying knots in laparoscopic surgeries. However, the rapid development and deployment of novel minimally invasive instruments presents the surgical educator with a significant challenge. For example, the AutoSuture™ EndoStitch™ device (US Surgical/Tyco) has been shown to reduce the time required for tying knots and produces knots of comparable, if not greater, strength than standard laparoscopic knot tying techniques. (Pattaras, John G., et al., “Comparison and Analysis of Laparoscopic Intracorporeal Suturing Devices: Preliminary Results”, J. Endourology 2001, 15:187-192). The mechanisms and techniques of operation for the EndoStitch™ device are detailed in U.S. Pat. Nos. 5,478,344; 5,478,345; and 5,480,406. However, these devices often require skills significantly different from those used for conventional surgical knot tying. As such, there can be a significant learning curve involved in developing the skills necessary to efficiently and effectively use new devices. (Tan, Andrew et al., J. Endourology 2005, 19(9):1104-1108). This is unacceptable in today's environment: throughput pressures in the operating room leave little room for delays or even minor mistakes.
In order to achieve proficiency, surgeons must be instructed and spend time using these suturing devices, or any other new instrumentation. However, maximizing trainee proficiency in a limited amount of time, while ensuring patient safety, has also proven to be very challenging. A variety of methods can be used for such practice, including anatomically correct models, videoscopic trainers, or, more realistic conditions, i.e., within excised organs, cadavers, or living animals. However, such practice requires time and in some circumstances travel by the surgeon to a practice site. In addition, actual suturing devices are often used during training. Many of the suturing devices are expensive and single-patient use, meaning that they must be properly disposed of after use on a single patient, or after a single practice session, and cannot be re-sterilized. As result, practice sessions with the actual devices can also be expensive since they must often be disposed of after each practice session.
Virtual environments have also been developed that simulate surgical environments in which surgeons can “practice” various techniques and instruments. Some of these virtual environments have also utilized haptic feedback devices (SensAble Technologies, Woburn, Mass.) to simulate the feel of touching or interacting with real tissues or organs. (Kim, M., Punak, S., Cendan, J., Kurenov, S., and Peters, J. 2006. Exploiting graphics hardware for haptic authoring. Proceedings of Medicine Meets Virtual Reality (MMVR) 14, Jan. 25-27, 2006, Long Beach, Calif., IOS Press, Amsterdam, Studies in Health Technology and Informatics (SHTI), 2006; 119:255-260; Hubbard, P. Collision Detection for Interactive Graphics Applications. IEEE Transactions on Visualisation and Computer Graphics. 1995; 1, No 3:218-230). Therefore, a need exists for a more convenient and less time-consuming way for surgeons to develop the necessary skills to efficiently utilize surgical devices, particularly laparoscopic suturing devices. A further need exists to reduce or eliminate the on-going expense of using multiple surgical devices in practice sessions.